2663 Essentials in Minimally Invasive Gynecology (Emig) Manual Skills Pilot Validation Trial

Abstract

Study Objective Evaluate the EMIG-FLS Laparoscopic Simulation System and the EMIG Hysteroscopy Simulation System for face validity and functionality in a pilot testing environment. Design A pilot cohort study Setting Three teaching institutions in the US Southwest Patients or Participants Twenty-seven residents and gynecologists who fit one of three categories of exposure to hysteroscopic and laparoscopic surgery and surgical simulation. Twelve were postgraduate year 1 (PGY-1); five were PGY-3, 1 was ABOG certified, and 5 were either fellows in-training or had completed a Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). Interventions After completing a screening survey, each subject was exposed to a structured orientation to the two simulation systems and then tested with proctor supervision on the 5 laparoscopic and 2 hysteroscopic exercises. A short 5-point Likert questionnaire designed to determine face validation and question clarity was administered to each subject at sites 2 and 3. Measurements and Main Results Face validity was high for each of the 7 exercises (means ranged from 4.8 to 4.9 out of 5) and subjects considered instructions to be clear (means ranged from 4.7 to 4.9). The recorded exercise times generally reduced with increasing levels of training although the sample sizes were not designed to determine significance given the pilot design. Similarly, exercise errors were generally less frequent with increasing experience. The systems, including the devices and recording mechanisms performed well and proctor evaluation and training were satisfactory. Conclusion The EMIG laparoscopic and hysteroscopic simulations systems were considered to have good face validity and appear to be suitable for a construct validation trial to confirm their utility in distinguishing amongst trainees and practitioners with a wide spectrum of endoscopic surgical experience. The recording and specimen storage mechanisms will allow for multiple proctors to rate a candidate's performance, thereby enhancing evaluation consistency and quality.